The Experts below are selected from a list of 183 Experts worldwide ranked by ideXlab platform
Guoming Luan - One of the best experts on this subject based on the ideXlab platform.
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Surgical outcomes and prognostic factors of drug-resistant epilepsy secondary to Encephalomalacia.
Epilepsia, 2019Co-Authors: Feng Zhai, Yuguang Guan, Jian Zhou, Guoming LuanAbstract:Objective To evaluate long-term outcomes and prognostic factors in patients who underwent surgical resection for drug-resistant epilepsy secondary to Encephalomalacia. Methods A total of 143 patients with drug-resistant epilepsy who underwent surgical resection with a follow-up of at least 5 years were included. Seizure outcomes were evaluated based on the International League Against Epilepsy classification. Univariate analysis and a multivariate logistic regression model in a backward fashion were used to identify the potential predictors of seizure outcomes. Results Three months after surgery, 102 of 143 (71.3%) patients had achieved favorable seizure outcomes. Five years after surgery, 107 of 143 (74.8%) patients had achieved favorable seizure outcomes. Changes in the postoperative seizure status were observed in 22 of 143 (15.4%) patients during follow-up, but the difference in the seizure-free rate between 3 months and 5 years after surgery was not significant. Univariate and multivariate analyses revealed that only a monthly seizure frequency of >30 seizures (odds ratio = 3.42, 95% confidence interval = 1.19-9.76) and bilateral ictal onset rhythms (odds ratio = 4.46, 95% confidence interval = 1.61-12.39) were independent predictors of unfavorable seizure outcomes. Significance Surgical resection is an effective treatment for patients with drug-resistant epilepsy secondary to Encephalomalacia. Knowledge of the predictors of seizure outcomes may help during preoperative counseling and selection of optimal candidates for epilepsy surgery among patients with drug-resistant epilepsy secondary to Encephalomalacia.
F. W. Sharbrough - One of the best experts on this subject based on the ideXlab platform.
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Resection of frontal Encephalomalacias for intractable epilepsy: Outcome and prognostic factors
Epilepsia, 1997Co-Authors: Noojan Kazemi, Russell K. Mosewich, Terence J. O'brien, G. D. Cascino, Max R. Trenerry, F. W. SharbroughAbstract:Summary: Purpose: Because focal Encephalomalacia is an important cause of medically intractable partial epilepsy and few studies have evaluated the efficacy and the safety of resecting focal Encephalomalacias to improve seizure control, we studied a cohort of 17 consecutive patients who underwent resection of Encephalomalacias in the frontal lobes as a treatment of their intractable epilepsy. Methods: We evaluated several factors for their value in predicting postsurgical seizure control. Pre- and postsurgical magnetic resonance imaging (MRI) scans were reviewed independently by 2 blinded investigators. Results: At a median of 3 years of follow-up (range 0.67.5 years), 12 patients (70%) were seizure-free or had only rare seizures. The presence of a focal fast frequency discharge (focal ictal p pattern) at the beginning of seizures on scalp EEG was predictive of seizure-free outcome (p = 0.017), even among patients who had complete resection of their Encephalomalacias (p = 0.016). There was no significant differences in outcome with regard to age at the time of the injury that caused Encephalomalacia, interval between injury and onset of seizures, duration of presurgical seizure history, presurgical seizure frequency, age at surgery, or the completeness of Encephalomalacia resection. The analysis regarding completeness of Encephalomalacia resection almost reached significance, suggesting that it may also be an important predictive factor (p = 0.051). Conclusions: We conclude that surgery is a very effective treatment for intractable frontal lobe epilepsy (FLE) secondary to Encephalomalacias. Patients are more likely to become seizure-free if they have a focal ictal /3 discharge on their scalp EEG. Complete resection of the Encephalomalacia should be attempted, since our results suggest that this may be a favorable predictive factor. Moreover, the operative strategy for our patients entailed, whenever possible, complete resection of the Encephalomalacias and of the adjacent electrophysiologically abnormal tissues. Key Words: Epilepsy-Surgery-Encephalomalacia-Posttraumatic-Frontal Lobectomy.
Feng Zhai - One of the best experts on this subject based on the ideXlab platform.
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Surgical outcomes and prognostic factors of drug-resistant epilepsy secondary to Encephalomalacia.
Epilepsia, 2019Co-Authors: Feng Zhai, Yuguang Guan, Jian Zhou, Guoming LuanAbstract:Objective To evaluate long-term outcomes and prognostic factors in patients who underwent surgical resection for drug-resistant epilepsy secondary to Encephalomalacia. Methods A total of 143 patients with drug-resistant epilepsy who underwent surgical resection with a follow-up of at least 5 years were included. Seizure outcomes were evaluated based on the International League Against Epilepsy classification. Univariate analysis and a multivariate logistic regression model in a backward fashion were used to identify the potential predictors of seizure outcomes. Results Three months after surgery, 102 of 143 (71.3%) patients had achieved favorable seizure outcomes. Five years after surgery, 107 of 143 (74.8%) patients had achieved favorable seizure outcomes. Changes in the postoperative seizure status were observed in 22 of 143 (15.4%) patients during follow-up, but the difference in the seizure-free rate between 3 months and 5 years after surgery was not significant. Univariate and multivariate analyses revealed that only a monthly seizure frequency of >30 seizures (odds ratio = 3.42, 95% confidence interval = 1.19-9.76) and bilateral ictal onset rhythms (odds ratio = 4.46, 95% confidence interval = 1.61-12.39) were independent predictors of unfavorable seizure outcomes. Significance Surgical resection is an effective treatment for patients with drug-resistant epilepsy secondary to Encephalomalacia. Knowledge of the predictors of seizure outcomes may help during preoperative counseling and selection of optimal candidates for epilepsy surgery among patients with drug-resistant epilepsy secondary to Encephalomalacia.
Noojan Kazemi - One of the best experts on this subject based on the ideXlab platform.
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Resection of frontal Encephalomalacias for intractable epilepsy: Outcome and prognostic factors
Epilepsia, 1997Co-Authors: Noojan Kazemi, Russell K. Mosewich, Terence J. O'brien, G. D. Cascino, Max R. Trenerry, F. W. SharbroughAbstract:Summary: Purpose: Because focal Encephalomalacia is an important cause of medically intractable partial epilepsy and few studies have evaluated the efficacy and the safety of resecting focal Encephalomalacias to improve seizure control, we studied a cohort of 17 consecutive patients who underwent resection of Encephalomalacias in the frontal lobes as a treatment of their intractable epilepsy. Methods: We evaluated several factors for their value in predicting postsurgical seizure control. Pre- and postsurgical magnetic resonance imaging (MRI) scans were reviewed independently by 2 blinded investigators. Results: At a median of 3 years of follow-up (range 0.67.5 years), 12 patients (70%) were seizure-free or had only rare seizures. The presence of a focal fast frequency discharge (focal ictal p pattern) at the beginning of seizures on scalp EEG was predictive of seizure-free outcome (p = 0.017), even among patients who had complete resection of their Encephalomalacias (p = 0.016). There was no significant differences in outcome with regard to age at the time of the injury that caused Encephalomalacia, interval between injury and onset of seizures, duration of presurgical seizure history, presurgical seizure frequency, age at surgery, or the completeness of Encephalomalacia resection. The analysis regarding completeness of Encephalomalacia resection almost reached significance, suggesting that it may also be an important predictive factor (p = 0.051). Conclusions: We conclude that surgery is a very effective treatment for intractable frontal lobe epilepsy (FLE) secondary to Encephalomalacias. Patients are more likely to become seizure-free if they have a focal ictal /3 discharge on their scalp EEG. Complete resection of the Encephalomalacia should be attempted, since our results suggest that this may be a favorable predictive factor. Moreover, the operative strategy for our patients entailed, whenever possible, complete resection of the Encephalomalacias and of the adjacent electrophysiologically abnormal tissues. Key Words: Epilepsy-Surgery-Encephalomalacia-Posttraumatic-Frontal Lobectomy.
Jian Zhou - One of the best experts on this subject based on the ideXlab platform.
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Surgical outcomes and prognostic factors of drug-resistant epilepsy secondary to Encephalomalacia.
Epilepsia, 2019Co-Authors: Feng Zhai, Yuguang Guan, Jian Zhou, Guoming LuanAbstract:Objective To evaluate long-term outcomes and prognostic factors in patients who underwent surgical resection for drug-resistant epilepsy secondary to Encephalomalacia. Methods A total of 143 patients with drug-resistant epilepsy who underwent surgical resection with a follow-up of at least 5 years were included. Seizure outcomes were evaluated based on the International League Against Epilepsy classification. Univariate analysis and a multivariate logistic regression model in a backward fashion were used to identify the potential predictors of seizure outcomes. Results Three months after surgery, 102 of 143 (71.3%) patients had achieved favorable seizure outcomes. Five years after surgery, 107 of 143 (74.8%) patients had achieved favorable seizure outcomes. Changes in the postoperative seizure status were observed in 22 of 143 (15.4%) patients during follow-up, but the difference in the seizure-free rate between 3 months and 5 years after surgery was not significant. Univariate and multivariate analyses revealed that only a monthly seizure frequency of >30 seizures (odds ratio = 3.42, 95% confidence interval = 1.19-9.76) and bilateral ictal onset rhythms (odds ratio = 4.46, 95% confidence interval = 1.61-12.39) were independent predictors of unfavorable seizure outcomes. Significance Surgical resection is an effective treatment for patients with drug-resistant epilepsy secondary to Encephalomalacia. Knowledge of the predictors of seizure outcomes may help during preoperative counseling and selection of optimal candidates for epilepsy surgery among patients with drug-resistant epilepsy secondary to Encephalomalacia.